Pharm 5

Front 1

adrenergic antagonists/blockers ex?

Back 1

*1. benign postatic hyperplasia (BPH)
2. htn
3. shi sweat
4. pheochromocytoma

Front 2

adrenergic antagonists/blockers se?

Back 2

ORTHOSTATIC
hypotension
N/V
nasal congestion & runny nose
inhibition of ejaculation

Front 3

bet adrenergic blocking agents (beta blockers) action & ex ?

Back 3

1. actions: competitively binds w/postsynaptic adrenergic membrane receptors, preventing normal activation by adrenergic neuortr.
2. common names generally end with -lol: *atenolol, *propranolol
3. rx for: *hypertension & ht disease, migraines, hyperthyroid, angina

Front 4

bet adrenergic blocking agents (beta blockers) se?

Back 4

bradycardia, arrthythmias-esp when stopped suddenly, metabolic disturbances-fasting hypoglycemia, - libido, failure to ejaculate, C extremities, fatigue, insomnia, nightmares, depression

Front 5

bet adrenergic blocking agents (beta blockers) CI?

Back 5

-do not discontinue abruptly
-*causes bronchoconstriction-CI in pt w/asthma or copd
-can cause CHF in some cases
-can cause hypoglycemia in diabetics
-*do not mix w/drugs that reduce av node conduction-bradyarrthythmias

Front 6

bet adrenergic blocking agents (beta blockers) chm CI?

Back 6

hei hu jiao (black peppter) + absorb kinetics of propranolol, + available concentration of both

Front 7

parasymapathetic receptors?

Back 7

-preganglionic & poastganglionic neurons use Ach as their neurotransmitter
-muscrinic receptors ( in this case, same as cholinergic receptors

Front 8

cholinergic agonists?

Back 8

1. + postsynaptic stimulation of a cholingergic neurons, just as Ach would
*postganlionic (parasympathetic)-where we see the effects of ANS
2. analogs of Ach w/longer durations of action
*acetylcholinesterases-break down Ach
-since these agents cannot be broken down by this enzyme they have longer duration effect

Front 9

cholinergic agonists tx?

Back 9

*atonic bladder:postpartum or postoperatively
*muscular weakness of myasthenia
*stimulates salivation in cases of xerostomia due to radiation

Front 10

cholinergic agonists se?

Back 10

general stimulation of cholinergic neurons
-constriction of pupils, diaphoresis, HA, urinary urgency, N, diar, htn, salivation, flushing, abd pain/cramp, ht palps, tremors, bronchospasms

Front 11

cholinergic agonists CI?

Back 11

-asthma
-hypotensive effects
can cause a cardiac event in a pt w/cardiac insufficiency

Front 12

cholinergic agonists herb-drug interactions?

Back 12

gan cao w/pilocarpine
-may tx overdose by + the metabolism of this drug

Front 13

anticholinesterase drugs (reversible)?

Back 13

-prevents the breakdown of Ach in the synaptic cleft, prolonging the activation of the postsynaptic membrane
-bind & reversibly inactivate AchE
-while reversible can be used therapeutically, irreversible= insecticides & nerve agents used in chemical warefare
-classified as WDM

Front 14

anticholinesterase drugs rx for?

Back 14

-muscular weakness mysathenis gravis
-cognitive weakness of alzheimers
-adhd in kids

Front 15

anticholinesterase drugs se?

Back 15

general stimulation of cholinergic neurons
-diaphoresis, ha, hypotension, urinary urgency, salivation, abd pain/cramps, bronchospasms, diarr

Front 16

anticholinesterase drugs interactions/?

Back 16

1. SOB-bronchospasm
2. Cholinergic effects can + gi motility
- absorption, effect elimination for those requiring exit through the intestines-rather than kds

Front 17

anti-muscarinic agent?

Back 17

-found on post synaptic membrane in parasympathetic ns
rx for:
*ibs
*parkinsons
-cough suppression
*diagnostic pupil dilation
-inhibits salivation & resp tract secretions
-N/V

Front 18

anti-muscarinic agent se?

Back 18

blurred vision, confusion, drowsiness, constipation, dry mouth, restlessness, HA, tachycardia, urinary retention

Front 19

anti-muscarinic agent interactions?

Back 19

-tachycardia can progress to suprventricular tachycardia & atrial fibrillation
-scopolomine for motion sickness can interact w/:
fu ling, dang gui, ren shen, shi chang pu, yuan zhi

Front 20

CNS?

Back 20

-made up of the brain & spinal cord
-cns presynaptic neurons release neurotra into the synaptic cleft, activating the postsynaptic membrane receptor, *causing voltage changes in the postsynaptic neuron

Front 21

cns vs ans?

Back 21

-cns uses *more neurotrans than ans
-neurons in cns have more connections with other neurons
-neurotra inhibit as well as excite postsynaptic neurons, making action more potentials more/less possible

Front 22

membrane potential & threshold?

Back 22

-an example of an interaction in which Ach is the neurotra. Achs role in the cns is very different than in the ans.
-Ach is only 1 of the many neurotra active in cns & that Ach is an excitatory neurotra in this case, making an action potential more likely

Front 23

depolarization?

Back 23

1. ion flow through ion channels can cause hyperpolarization or depolarization, depending on which ions flow in or out and how much change in charge occurs
-think of depolarization & hyperpolarizing as directions on a continuum
-hyper=inhibitory
-depol-excitatory
2. sufficient depolariztion initiates an action potential
3. depolarization is called an excitatory post-synaptic potential-epsp
-+ likelihood of a nerve impulse
-caused by an influx of Na ions.This makes the - int. of the cell less - (more +) by the addition of + charged ions
-nore & epi are common epsp neurotra in cns

Front 24

hyperpolarization?

Back 24

1. inhibitory post synpatic potential (ipsp) come from hyperpolarization of the postsynaptic membrane reducing the likelihood of generating an action potential
-caused by an influx of CL ions or outflow of Na ions
-makes the int of the cell membrane more - makes it more difficult to depolarize & thus more difficult to cause an action potential
-gaba & glycine common ipsp neurotra

Front 25

cns neurons?

Back 25

-most recive both epsp & ipsp
*the sum of these determines if an action potential will be initiated

Front 26

drugs of cns?

Back 26

-parkinsons
-anxiolytic & hypnotic
-cns stimulants
-antidepressants
-mania
-anti psychotics/neuroleptics
-opioid analgesics

Front 27

parkinsons etiology?

Back 27

1. cells in substantia nigra produce dopamine. *these cells are degenerated
2. the basal nuclei aid in motor movements

Front 28

parkinsons tx?

Back 28

1. scalp in tcm
2. wm is to + dopamine
*directly supplementing a dopamine precursor (levodopa)
*- of peripheral metabolism of levodop (carbidopa)

Front 29

parkinsons drug combinations?

Back 29

-*carbidopa allows more absorption of the levodopa (otherwise 1% only 1% would enter the brain)
-amantadine: antiV for influenza
-mao inhibitors reduce the breakdown of dopamine
-SE: shi stimulation of cns, hallucinations

Front 30

parkinsons interations?

Back 30

-vit b6 reduces effectiveness of levadopa by + peripheral metabolism

Front 31

anxiolytic & hypnotic (sed) drugs?

Back 31

1. anxiety & insomnia
-anxiety
fear, apprehension, uneasiness, tension, known or unknown sourse, trembling,sweating, tachycardia
-anxiolytics can be sedating. hypnotics are also used to reduce anxiety

Front 32

anxiolytic & hypnotic (sed) drugs types?

Back 32

1. barbiturates
2. benzodiazepines-can also be used as muscle relaxants & anti convulsants

Front 33

mech of action benzo?

Back 33

-bind to a specific benzo receptor adjacent to the gaba receptor
-this binding enhances gaba binding to its receptors
-gaba binding prolongs the length of time that Cl channels are open
-Cl influx leads to hyperpolarization

Front 34

anxiolytic & hypnotic (sed) drugs CI?

Back 34

-never use w/alcohol or other cns depressants
-used as muscle relaxants, anti anxiety, anticonvulsant/hypnotics

Front 35

anxiolytic & hypnotic (sed) drugs types?

Back 35

*diazepam, lorazepam

Front 36

anxiolytic & hypnotic (sed) drugs se?

Back 36

-dependence, withdrawl, rebound insomnia, drowsiness, confusion, HA, blurred vision, vertigo, N/V, diarreha, pain, incontinence, intellectual impairment

Front 37

anxiolytic & hypnotic (sed) drug chm interaction?

Back 37

1. + effects
bai jiang cao, bai shao, long dan cao, shen calming herbs, suan zao ren, tian ma, zhi zi
2. other interactions
-bai he, + sleeping
-chan tui, sedative effect
-hu po, sedative effect
-gan cao, tx overdoses

Front 38

cns stimulants?

Back 38

-addictive
1. psychotomimetic/hallucinogenic drugs
2. psychomotor stimulants

Front 39

psychotomimetic/hallucinogenic drugs?

Back 39

1.psychosis mimicking
-lsd:
-pcp:
-thc:

Front 40

psychomotor stimulatns?

Back 40

-amphetamines & methylxanthines
-OTC stimulants & pain relievers
-amphetamines & cocaine
-nicotine from cigarettes
-OTC smoking cessation products

Front 41

psychomotor stimulants: methylxanthisnes?

Back 41

1. *theophylline (tea) ,theobromine (cocoa), caffiene (coffee, tea, ect
-+ mental alertness, - fatigue, anxiety/tremors at high levels
-+ inotropic, + chronotropic effects on ht
-mild diuretic
-can stimulate HCI secretion from gastric mucosa
-relax smooth mm of bronchioles

Front 42

cns stimulants: chm interactions?

Back 42

-chan tui: inhibitory effect on cns
-*gan cao: tx OD by + metabolism of certain drugs (barbs, cocaine, pilocarpine, nicotine, caffeine)
-gou teng: reverses caffeins stimulating effects w/o affecting the use of barbs
-*ma haung: may + adrenergic stim, themogenesis & weigh loss of theophylline, + se of caffeine
-*suan zao ren: sedative & hypnotic effects
-niu huang: has mild sed effect